Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Provider Service Representative I’s major responsibility is to professionally respond to telephone inquiries from providers & related entities. The questions will be concerning but not limited to benefits, eligibility, plan coverage, enrollment status, claims adjudication process, billing, and payments for Martin’s Point USFHP Program and Medicare programs. Job Description Key Outcomes: Answers verbal, written and electronic inquiries with complete and accurate information and educates when possible regarding Martin’s Point USFHP and Medicare program’s policies, procedures and self- service options. Responds to incoming inquiries and partners with provider on possible next steps and or resolution. This should be completed within the timeframes outlined in Representative Expectations document. Collaborates with PI Research team and or other departments when needed to resolve Provider issues. Follows up in a timely manner with providers when first call resolution is not possible. Stays educated on existing and new information available through Provider Services internal resources. Documents all provider inquiries with accurate and detailed information according to correct template, including the resolution and next steps of the inquiry. Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
501-1,000 employees